The first major study looking at the effects of long COVID in children was recently published in JAMA. The National Institutes of Health-funded research provides information about the common chronic symptoms kids experience after a COVID infection.

“This is, to my knowledge, the biggest, multicenter description of different flavors of pediatric long COVID that I’ve seen,” said Dr. Matt Ambrose, a pediatric cardiologist for M Health Fairview.

He helped spearhead the first pediatric clinic dedicated to POTS in the Twin Cities, which stands for postural orthostatic tachycardia syndrome. POTS shares qualities with long COVID, which is also treated at the clinic.

“We’re really busy,” Ambrose said. “I see a new patient multiple times a week, every week.”

Long COVID patients he’s treated exhibit symptoms including chronic fatigue, dizziness when standing, difficulty with focus, chronic pain, fast heartbeats and nausea. The research published in JAMA last month reinforces those clinical presentations, according to Ambrose.

The study included 3,860 children and adolescents with a COVID infection history at more than 60 sites across the nation between March 2022 and December 2023, according to NIH. Another 1,516 children and adolescents without a COVID history were also included for the sake of comparison.

It found headache, trouble with memory or focusing, trouble sleeping and stomach pain were the most common symptoms among children 6 to 11 years old.

Tiredness or low energy; body, muscle or joint pain; headaches; and trouble with memory or focusing were the most common symptoms for adolescents 12 to 17 years old, according to the research.

“Kids change and so symptoms change and what was fascinating about this study is really they were able to identify some differences in how long COVID may present,” said Dr. Andrea Singh, the department chair of Park Nicollet Pediatrics.

She also said the symptoms noted in the study are the same as what patients are experiencing at Park Nicollet clinics. The chronic symptoms broadly affect young patients’ lives.

“Life may be less forgiving,” Singh said. “There are school requirements, they have to show up otherwise they might be dealing with truancy claims and things like that. They have sports and other cocurricular activities. They need to fulfill an obligation.”

Children may have difficulty explaining the symptoms they’re experiencing as well, such as brain fog. Singh suggests parents look for changes in their child’s physical condition or behavior to identify possible cases of long COVID.

“Kids will often manifest any signs of chronic illness by having behavior changes, so whether they get a little more fussy, a little more cranky,” she explained. “Adolescents can be a little more withdrawn or snap at you a little bit faster than they otherwise would.”

She added, “It looks like a lot of other things, and that’s what’s hard. You almost have to rule out those other things sometimes before you get to the long COVID diagnosis and that can take time.”

The research will help provide another tool to improve care, according to Singh. She called it “a step in the right direction.”

Ambrose agrees the quality data will have long-term benefits.

“It is really useful for categorizing children for future research and potentially hopefully in the future directed therapeutic interventions,” he said.

Currently, he works with patients to increase hydration along with aerobic and strength training.

“The hope is that, yes, many people will outgrow many of these symptoms over time but it’s not a guarantee,” Ambrose said.